New Medicaid 'Education' Group Launches

First step: inform lawmakers, public about the program

WASHINGTON -- Leaders of a new Medicaid coalition gathered Thursday to announce their group's formation, and said their immediate goal will be to educate lawmakers and the public about the federal-state program.

A group of 27 organizations held a briefing to introduce the Modern Medicaid Alliance, an organization that will "educate policymakers and the public about the benefits of Medicaid to the American people and highlight how innovative health solutions in Medicaid improve outcomes and lower costs," according to the alliance's press release.

Members of the alliance include America's Health Insurance Plans (AHIP) -- some of whose members have contracts to provide care for Medicaid beneficiaries through various Medicaid managed care programs -- as well as the Children's Hospital Association, the National Patient Advocate Foundation, the Partnership to Fight Chronic Disease, the Healthcare Leadership Council, and the Academy of Managed Care Pharmacy. Membership also includes professional and healthcare provider organizations.

For the time being, at least, the alliance will be housed at the offices of AHIP, which started the organization, AHIP CEO Marilyn Tavenner said at the briefing. "We don't have a lobbying agenda at this point; it's purely education," Tavenner said. "There is so much education that needs to go on ... not only in Congress but with the public at large. Understanding the number of people in the program, what it covers, and what the costs are, are three things to start with." Funding decisions for the alliance will be made later by the group's leadership, she told MedPage Today in an interview.

There are several misconceptions about the Medicaid program that alliance members would like to clear up, said Mark Wietecha, president and CEO of the Children's Hospital Association. He noted that 30 million of Medicaid's 70 million beneficiaries are children, "and if you add in the [Children's Health Insurance Program], nearly half the children in the country are on a public program for healthcare ... The perception of Medicaid is that it's a program for adults without insurance."

In addition, provider issues must be addressed, he continued. "If you have a hospital full of patients, and physicians are completely busy in their practices, they're hard-pressed to add Medicaid patients when in fact Medicare [has] considerably higher reimbursement," and commercial insurance reimburses even higher than that, he said. "If we can't engage the provider community more fundamentally, we will have a hard time moving forward as we would like ... Medicaid is not the top of most providers' lists, and that's something we have to address."

Medicaid reimbursement also varies widely by state, Tavenner said. Although most states reimburse at lower rates than Medicare -- which itself just covers costs for most providers -- in Alaska and Oklahoma, for example, reimbursement is higher than Medicare. "As we look at workforce issues, reimbursement is vital on one side, but also workforce training and increase in the supply of the workforce are equally important."

Mary Grealy, president of the Healthcare Leadership Council, a coalition of healthcare groups including provider organizations and pharmaceutical companies, said she saw two main themes for education: "One is economics. We need to make sure we're funding at an appropriate level to make sure there is access to providers and services. And flexibility is extremely important -- using the whole healthcare team -- letting everyone practice to the limit and scope of their licensure is absolutely critical, and having flexibility at the federal level, letting states come in and try innovative programs."

Medicaid also should support research by reimbursing for clinical trial work, said Gary Puckrein, PhD, president and CEO of the National Minority Quality Forum. In addition, "We need to get better data from Medicaid. If there are 70 million consumers in the program, they have rich set of information; if we begin to share it using big data analytics, that's where our future is."

Getting attention for Medicaid can be difficult in the nation's capital, where lawmakers are more focused on the elderly population, Wietecha said. "Here in Washington there is a great and focused interest on Medicare -- it has 50 million voters in it," he said. "We find just a shadow of the same attention on Medicaid," a program that includes millions of children, who obviously can't vote. "We're going to have to find a way to raise awareness that kids are so vitally covered in this program."

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